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Centrale pontine Myelinolyse

Pathogenetische Aspekte aufgrund morphometrischer Untersuchungen des Brückenfußes

Central pontine myelinolysis

Pathogenic aspects with reference to morphometric studies of pontine basis

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Summary

23 cases of central pontine myelinolysis (CPM) were investigated histopathologically. According to the degree of glial reaction, two groups could be distinguished—those of early (8 cases) and late (15 cases) phases.

In the early phase, oligodendroglial cells presented various signs of degeneration particularly coagulation necrosis or karyorrhexis. In the late phase, no obvious oligodendroglial degeneration was found.

Good correlation existed between the degree of demyelination and that of degeneration or loss of oligodendrocytes.

In areas of demyelination, neurons presented various nonspecific changes in all early phase cases; in addition, multifocal acute anoxic damage of nerve cells was found in 4 early phase cases (50%). In the late phase, spheroids and retrograde neuronal degeneration or nonspecific changes were observed, but no anoxic damage.

Astrocytes frequently showed nuclear swelling and, in some late phase cases, slight cellular increase without fibrillar gliosis. According to these findings, acute oligemic anoxia, happening but once, is suggested to cause CPM.

Structural peculiarities of the pontine base were studied morphometrically in 2 normal control cases; the findings support a hypothesis of the possibility of a “vascular steal”-phenomenon which may cause oligodendroglial damage in case of sudden hypotension. Reasons for the specific localisation of CPM in the pontine base are discussed.

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Authors and Affiliations

  1. Neurologisches Institut der Universität Wien, Wien, Österreich

    Riki Okeda

  2. Dept. of Pathology, Tokyo Med. & Dent. Univ., Yushima 1, Bunkyo-ku, Tokyo, Japan

    Riki Okeda

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  1. Riki Okeda
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Okeda, R. Centrale pontine Myelinolyse. Acta Neuropathol 27, 233–246 (1974). https://doi.org/10.1007/BF00687633

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  • DOI: https://doi.org/10.1007/BF00687633

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